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What stories do you tell yourself?
Our internal narratives affect our everyday life and health.
Today’s newsletter is about the stories we tell ourselves and their effect on our health.
Today’s podcast is one of my all-time favorites! It’s about quieting our inner critic and overcoming imposter syndrome. Take a listen here!
In this week’s Q&A, I welcome your questions about how to rewrite a personal narrative that has negatively affected your health. Send me your questions here!
I have a confession to make: I have never listened to my own podcast. Despite positive feedback, I cringe at the sound of my own voice. Despite my passion for broadening the definition of health, there’s a voice inside me saying, You’re Doing It Wrong.
I recently saw a patient who has convinced herself that she’s not good enough. This narrative was born at a young age when she was teased in grade school for having difficulty learning to read. Her feelings of inadequacy were compounded by the absence of adequate support at home and at school. By high school she was depressed and binge eating. By college she had developed a drinking problem and a full-blown eating disorder.
She is not alone. We all have stories that we tell ourselves, some of which are rooted in reality and some that are not fact-based. Sometimes the stories stem from childhood. Sometimes they result from an adverse experience. Sometimes they reflect a cultural reality—like misogyny or racism—that we cannot easily change. The voices can be cruel, even punishing, when they tell us, for example, that we’re unattractive, unfit, or unworthy of love.
These narratives can directly inform our self-esteem, relationships, behaviors and health—especially when we follow their script.
Negative self-talk isn’t a new concept to me. I’ve spent my adult life trying to fact-check the narratives that inhabit my brain, amplifying voices of self-compassion and muting murmurs of self-doubt. I’ve learned that shame and fear can silence one’s authentic voice. I’ve realized that humility and self-confidence can coexist. I try to bring these lessons with me in my roles as a parent, doctor, and patient.
Thank you for supporting this work! Together, we’re changing the conversation about what it means to be healthy.
When my patient’s blood pressure and weight were elevated in my office, she cried out, I know better. What is wrong with me?? The unfavorable metrics were, to her, further evidence of personal failure. So I asked her, Where is this punishing voice coming from? It turns out that her negative thought patterns stem from childhood trauma—and they have everything to do with her chaotic relationships with food and alcohol.
Unsurprisingly, research has shown that adverse childhood experiences (ACEs) can negatively affect our mental and physical health. ACEs are relatively common. According to a landmark study conducted by the CDC and Kaiser Permanente in the 1990s, nearly two-thirds of adults surveyed reported at least one type of ACE—from emotional neglect to physical abuse.
But health is not defined by our inner critic. We are the integrated sum of complex parts. Health is about having awareness about the stories we tell ourselves, acceptance over the things we can't control, and more agency over our life. It starts with having access to fact-based information to care for our body and mind.
My advice to my patient?
To access the harmful internal narratives, to recognize their roots, and—without judgment—to see their relevance to her habits around eating and drinking. I can prescribe medications for high blood pressure, but there’s no quick fix for self-awareness and self-compassion.
To work on radically accepting the emotional abuse and neglect she experienced as a child. Instead of punishing her body, she needed to listen to its cues. Though a combination of psychotherapy, mindfulness techniques, and medication, she learned to cope with distress in healthier ways.
To focus on the areas where she has agency. For example, simply recognizing that her inner critic is particularly loud when she is tired or stressed out helped her prioritize rest and self-care. Not surprisingly, her blood pressure and weight improved when she was sober, rested and well-nourished.
Sometimes the best way to quiet an inner critic is a dose of self-compassion.
Our stories live in our bodies.
No one knows this better than this week’s podcast guest, Dr. Suzanne Koven. She is a master storyteller and primary care doctor at Harvard Medical School. In caring for patients for 30 years, Dr. Koven learned that patients are more than a set of organs.
“There is nothing that I can think of, there is no kind of testing, there is no sort of physiology or pharmacology that is more essential to clinical skill than the ability to elicit, interpret and communicate someone else’s story.”
It turns out that Dr. Koven has a story, too. Despite her accomplishments and accolades, as a young woman she felt like an imposter—a surprisingly common sentiment for career-oriented females. Her memoir, Letter to a Young Female Physician, is a series of personal essays that reveals the importance of identifying negative self-talk. The book is a must-read for women physicians and for anyone experiencing self-doubt. In it, she explores the art of authoring our own stories.
On this episode of Beyond the Prescription, Dr. Koven discusses with me how her own process of self-discovery improved her own health. Her humility and humor are just what the doctor ordered.
Everyone has a story. What’s yours?
Please share your (healthy or not-so-healthy) internal narrative and/or your favorite mental and physical health tip below! Over time, this will blossom into a community bulletin board of collective wisdom—with advice from me along the way.
Caring for people is a team sport! Thank you for being here with me.
Disclaimer: The views expressed here are entirely my own. They do not reflect those of my employer, nor are they a substitute for advice from your personal physician.